According to the evidence, people with Atherosclerotic Cardiovascular Disease (ASCVD) are a Heterogeneous Population, with some having a higher risk than others. In these patients, further reducing Low-density Lipoprotein Cholesterol (LDL-C) can..Read More

Heart failure (HF) is a serious problem in India with high mortality, a high rate of recurrent hospitalization and poor quality of life.Four foundational groups of medicines have improved the outcome greatly, but the uptake in India is still ver..Read More

The National Medical Commission (NMC) has formulated NMC guidelines 2022 for medical professionals to follow in their professional activities. The salient features are:Continuing professional development program: A registered medical practitione..Read More

Lipoprotein apheresis is a very efficient but time consuming and expensive method of lowering levels of LDL-C, lipoprotein(a) [Lp(a)] and other apoB-containing lipoproteins, including triglyceride (TG)-rich lipoproteins.Lipoprotein apheresis is ..Read More

Cardiovascular disease is the leading cause of death, attributing to 28% of the total mortality in the Indian population with an average age of onset below 55 years.Contribution of familial hypercholesterolemia (FH) to premature CVD in Indians i..Read More

Cardiovascular disease in India is challenging as it occurs at a young age.Dyslipidemia is one of the biggest risk factors for CVD.Statins are an opportunity in India.Statins have now become one of the most prescribed drugs for both primary and ..Read More

LDL-C is universally accepted as a major driver of atherosclerosis. Higher the baseline LDL, the higher the risk.Low and very low LDL levels are safe/effective in reducing CV events further, as shown by PCSK9 trials. Target LDL-C must be achieve..Read More

Modern registries have emerged as one of the important clinical research tools for understanding a disease in all its dimensions and the influence of interventions on them in the “real world”.They may unravel the outlook of medical practices..Read More

Substantial ASCVD risk persists despite low levels of LDL-C and elevated TGs, and their remnants account for a portion of this residual risk.Combination therapy of statins with fibrates or niacin has not shown effectiveness and is generally not ..Read More

High blood pressure (BP) is the most important cause of global mortality and morbidity.Management of hypertension should move away from the “number-based” approach to “risk-based” therapy.Raised LDL-C is the most important CVD/CAD risk f..Read More

Heart failure is extremely frequent, often forgotten and fatal in diabetes.Diabetes changes the cardio-metabolic fingerprints leading to a predisposition to HF, independent of atherosclerotic disease; this effect is exaggerated by coincident ren..Read More

Measurement of LDL-C and HDL-C are inaccurate, so why measure?All the apoB-containing particles are atherogenic; the measurement of apoB encompasses all of them, which must be reduced.On treatment, apoB reduction is a better marker. The discorda..Read More

Therapy for severe FH:Pharmacotherapy – lipid-modifying drugsExtracorporeal removal of LDL-apheresisSurgical therapy – portacaval shunt, partial bypassMethods to restore LDL receptor activity – liver transplantation, gene therapy.Despite t..Read More

Studies show 15% to 25% LDL-C reduction on background statin therapy; higher LDL-C reduction in patients not on statins.Combination of bempedoic acid and ezetimibe lowers LDL-C by about 35% to 40%.Bempedoic acid not activated in muscle.Overall g..Read More

Nonfasting samples can be used to measure total cholesterol (TC), HDL-C and HDL-C.TG can be measured in a nonfasting state, but reference intervals in a nonfasting form must be established for the same in larger populations.For patients, laborat..Read More

Familial hypercholesterolemia is a highly atherogenic disorder.The risk of CHD is increased 10- to 20-fold.Phenotype is highly variable.Genetic testing may be beneficial in some patients.Clinical diagnosis of FH is based on:Personal and family h..Read More

ASCVD risk remains high in patients who have attained the guideline – recommended LDL-C goals.In some circumstances like diabetes, obesity or very low LDL-C, it may underestimate the risk conferred by other apoB-containing lipoproteins.In thes..Read More

Preventive cardiology efforts begin with the assessment of CVD risk.Risk assessment algorithms include the European SCORE, PROCAM, QRISK, FRAMINGHAM and the US Pooled Cohort Risk Equation (PCE).Despite many available risk assessment approaches, ..Read More

Familial hypercholesterolemia has been considered as one of the major causes of premature ASCVD, with carotid ultrasound being one of the most popular and noninvasive methods for assessing atherosclerosis among pediatric patients with FH.Carotid..Read More